CPT Code Overview

CPT 27507 describes the open surgical treatment of a femoral shaft fracture using plate and screws, with or without cerclage. This procedure falls under Orthopaedic Surgery and is typically performed in an inpatient hospital operating room or procedure room. The code captures cases where internal fixation with plates and screws is used to stabilize femoral shaft fractures via an open approach.

Clinical Context

A typical patient is an adult admitted to the inpatient hospital following high-energy trauma (for example, a motor vehicle collision or fall from height) with an acute femoral shaft fracture. The patient presents with severe thigh pain, deformity, and inability to bear weight. Imaging (plain radiographs and often CT) confirms a displaced femoral shaft fracture or fracture pattern requiring open reduction and internal fixation.

Preoperative workflow includes emergency department evaluation, neurovascular assessment of the limb, pain control, and templating for fixation. The patient is taken to the operating room where an orthopaedic surgeon performs open reduction of the femoral shaft fracture and internal fixation using a plate and screws, with cerclage wires if needed. Postoperative care typically occurs in the inpatient setting with pain management, thromboprophylaxis, neurovascular checks, and initiation of physical therapy as appropriate.

Coding Specifications

• Modifier 51 (Multiple Procedures): Used when multiple, distinct surgical procedures are performed during the same operative session. Apply when 27507 is one of several procedures and payer guidelines require reporting of the additional procedure(s) with modifier 51.

• Modifier 59 (Distinct Procedural Service): Used to indicate a procedure or service that is distinct or independent from other services performed on the same day. Apply when 27507 represents a separate service from another procedure on the same date that might otherwise be bundled.

• Associated Provider Taxonomies:

These taxonomies represent surgeons who typically perform open treatment of femoral shaft fractures and related orthopaedic operative care.

Related Diagnoses

• S72.001A — Fracture of unspecified part of neck of right femur, initial encounter for closed fracture.

  Clinical relevance: A femoral neck fracture may coexist with or be differentiated from shaft fractures; accurate diagnosis supports selection of appropriate femoral fixation procedures.

• S72.002A — Fracture of unspecified part of neck of left femur, initial encounter for closed fracture.

  Clinical relevance: As above, identifies laterality and fracture location relevant to operative planning and coding.

• S72.031A — Displaced fracture of base of neck of right femur, initial encounter for closed fracture.

  Clinical relevance: Displaced femoral neck fractures are clinically significant for surgical fixation; distinguishing base/neck location informs choice of procedure.

• S72.032A — Displaced fracture of base of neck of left femur, initial encounter for closed fracture.

  Clinical relevance: As above for the left side; supports correct association with operative treatment.

• M84.451A — Pathological fracture in neoplastic disease, right femur, initial encounter.

  Clinical relevance: Pathological fractures due to neoplasm may alter surgical approach and fixation strategy; coding this diagnosis documents underlying bone pathology associated with the fracture.

Related CPT Codes

27506 is an alternative operative technique for femoral shaft fractures when intramedullary nailing is selected instead of plate-and-screw fixation represented by 27507. In some clinical workflows, 27506 may be chosen over 27507 based on fracture pattern and surgeon preference.

27508 describes closed treatment of distal femoral condylar fractures and is a different anatomic site and technique; it may be performed in the same care episode for concomitant distal femur injuries but is not the same procedure as 27507.

Common usage: 27506 is commonly considered an alternative to 27507. 27508 is a related but distinct code for distal femur injuries and may be reported separately when clinically indicated.

National commercial mean rates are materially higher than Medicare for CPT 27507. Blue Cross Blue Shield, Cigna, UnitedHealth Group, and BUCA all report mean allowed rates above Medicare’s mean of $896.77, with UnitedHealth Group highest at $1,744.53 and Cigna at $1,632.93; BUCA (average commercial) has a mean of $1,270.51, which is about $373.74 higher than Medicare.

Dispersion (P75 minus P25) varies across payers. UnitedHealth Group and Cigna show the widest dispersion (UHC: $996.00; Cigna: $946.50), indicating broader variation in allowed rates. Aetna and Medicare are the tightest (Aetna: $434.50; Medicare: $68.00), with Medicare exhibiting the narrowest interquartile spread. The table and chart below present the full breakdown.